SPLENORENAL ARTERIAL BYPASS IN A CHILD WITH TAKAYASUS DISEASE - A CASE-REPORT

In adults splenorenal arterial bypass is a highly effective treatment for renovascular hypertension, but in children the procedure has been less successful because of the small size of the splenic artery. Howev er, with the improvement in microvascular techniques the procedure is now possible in children. A 2-year-old child with Takayasu's arteritis , previous right nephrectomy and severe renovascular hypertension requ ired revascularization to salvage his remaining left kidney. A splenor enal arterial bypass was performed through a left retroperitoneal flan k incision. Postoperatively his creatinine level returned to normal an d his requirements for antihypertensive medication were markedly dimin ished. The advantages of a splenorenal arterial bypass for left renal revascularization in a developing child are discussed.